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Integrated 18F–FDG PET/MRI compared to MRI alone for identification of local recurrences of soft tissue sarcomas: a comparison trial

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To assess and compare the diagnostic accuracy of PET/MRI and MRI alone for the detection of local recurrences of soft tissue sarcomas (STS) after initial surgical resection of the primary tumors.

Material and methods

A total of 41 patients with clinically suspected tumor relapse of STS underwent an 18F–FDG-PET/MRI examination for assessment of local recurrence. Two experienced physicians interpreted the MRI data and subsequently the PET/MRI datasets in two separate reading sessions and were instructed to identify potential local tumor recurrences. Additionally, the diagnostic confidence in each reading for the identification of malignant lesions was determined. A McNemar test was applied to test for differences of both ratings and a Wilcoxon signed-rank test was used to identify differences of the confidence levels. Histopathological verification and follow-up imaging were applied for standard of reference.

Results

Tumor relapse was present in 27/41 patients. Calculated sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the detection of local tumor recurrence was 82%, 86%, 92%, 71% and 83% for MRI, and 96%, 79%, 90%, 92% and 90% for PET/MRI (p > 0.05). Furthermore, PET/MRI showed significantly higher confidence levels (p < 0.05) for the determination of malignant lesions.

Conclusion

Our results endorse 18F–FDG PET/MRI to be an excellent imaging method in the evaluation of recurrent STS after surgical excision, yielding superior tumor detection when compared to MRI alone.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany

    Youssef Erfanian, Johannes Grueneisen, Axel Wetter, Michael Forsting & Lale Umutlu

  2. Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany

    Julian Kirchner

  3. Sarcoma Surgery Division, Department of General-, Visceral- and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Lars Erik Podleska

  4. Division of Solid Tumor Translational Oncology, Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Sebastian Bauer

  5. Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Thorsten Poeppel & Ken Herrmann

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  1. Youssef Erfanian
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Correspondence to Youssef Erfanian.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Erfanian, Y., Grueneisen, J., Kirchner, J. et al. Integrated 18F–FDG PET/MRI compared to MRI alone for identification of local recurrences of soft tissue sarcomas: a comparison trial. Eur J Nucl Med Mol Imaging 44, 1823–1831 (2017). https://doi.org/10.1007/s00259-017-3736-y

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